The severity of knee osteoarthritis is graded using the 5-point Kellgren-Lawrence (KL) scale where healthy knees are assigned grade 0, and the subsequent grades 1-4 represent increasing severity of the affliction. Although several methods have been proposed in recent years to develop models that can automatically predict the KL grade from a given radiograph, most models have been developed and evaluated on datasets not sourced from India. These models fail to perform well on the radiographs of Indian patients. In this paper, we propose a novel method using convolutional neural networks to automatically grade knee radiographs on the KL scale. Our method works in two connected stages: in the first stage, an object detection model segments individual knees from the rest of the image; in the second stage, a regression model automatically grades each knee separately on the KL scale. We train our model using the publicly available Osteoarthritis Initiative (OAI) dataset and demonstrate that fine-tuning the model before evaluating it on a dataset from a private hospital significantly improves the mean absolute error from 1.09 (95% CI: 1.03-1.15) to 0.28 (95% CI: 0.25-0.32). Additionally, we compare classification and regression models built for the same task and demonstrate that regression outperforms classification.
Knee-xRAI: An Explainable AI Framework for Automatic Kellgren-Lawrence Grading of Knee Osteoarthritis
Orthopaedic Department, Faculty of Medicine UIN Syarif Hidayatullah Jakarta（乌姆尼大学医学学院骨科部）；Informatics Engineering, Institut Teknologi Sepuluh Nopember（十月份技术研究所信息工程系）；Information Technology, Universitas Muhammadiyah Yogyakarta（尤科阿卡塔大学信息技术系）；Industrial and Systems Engineering, King Fahd University of Petroleum and Minerals（国王法赫德石油与矿物大学工业与系统工程系）
From Kellgren-Lawrence to Calcium Pyrophosphate Crystal Deposition: A Soft-Labelling Framework for Knee Osteoarthritis Assessmen
organization= Department of Political Science, Communication；International Relations, University of Macerata , city= Macerata , country= Italy；organization= Department of Economics；Law, University of Macerata , city= Macerata , country= Italy；organization= Department of Innovative Technologies in Medicine \& Dentistry, Università degli Studi "G. D'Annunzio" Chieti - Pescara , city= Chieti , country= Italy；organization= Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche , city = Ancona , country= Italy；organization= Academic Rheumatology, University of Nottingham , city = Nottingham , country= UK；organization= Department of Rheumatology, Polytechnic University of Marche , city= Ancona , country= Italy
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）
Knee osteoarthritis (OA) is the most common musculoskeletal disease in the world. In primary healthcare, knee OA is diagnosed using clinical examination and radiographic assessment. Osteoarthritis Research Society International (OARSI) atlas of OA radiographic features allows to perform independent assessment of knee osteophytes, joint space narrowing and other knee features. This provides a fine-grained OA severity assessment of the knee, compared to the gold standard and most commonly used Kellgren-Lawrence (KL) composite score. However, both OARSI and KL grading systems suffer from moderate…
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；KU Leuven（鲁汶大学）；Ailean Technologies Oy
Knee osteoarthritis (OA) is one of the highest disability factors in the world. This musculoskeletal disorder is assessed from clinical symptoms, and typically confirmed via radiographic assessment. This visual assessment done by a radiologist requires experience, and suffers from moderate to high inter-observer variability. The recent literature has shown that deep learning methods can reliably perform the OA severity assessment according to the gold standard Kellgren-Lawrence (KL) grading system. However, these methods require large amounts of labeled data, which are costly to obtain. In thi…
Insight Centre for Data Analytics, Dublin City University（都柏林城市大学数据洞察中心）；School of Health and Human Performance, Dublin City University（都柏林城市大学健康与人体表现学院）
This paper proposes a new approach to automatically quantify the severity of knee osteoarthritis (OA) from radiographs using deep convolutional neural networks (CNN). Clinically, knee OA severity is assessed using Kellgren \& Lawrence (KL) grades, a five point scale. Previous work on automatically predicting KL grades from radiograph images were based on training shallow classifiers using a variety of hand engineered features. We demonstrate that classification accuracy can be significantly improved using deep convolutional neural network models pre-trained on ImageNet and fine-tuned on knee O…
University of Oulu（奥卢大学）；Tampere University of Technology（坦佩雷理工大学）；Oulu University Hospital（奥卢大学医院）
Knee osteoarthritis (OA) is the most common musculoskeletal disorder. OA diagnosis is currently conducted by assessing symptoms and evaluating plain radiographs, but this process suffers from subjectivity. In this study, we present a new transparent computer-aided diagnosis method based on the Deep Siamese Convolutional Neural Network to automatically score knee OA severity according to the Kellgren-Lawrence grading scale. We trained our method using the data solely from the Multicenter Osteoarthritis Study and validated it on randomly selected 3,000 subjects (5,960 knees) from Osteoarthritis …
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Medical Research Center, University of Oulu and Oulu University Hospital（奥卢大学与奥卢大学医院医学研究中心）
Objective: To assess the ability of imaging-based deep learning to predict radiographic patellofemoral osteoarthritis (PFOA) from knee lateral view radiographs. Design: Knee lateral view radiographs were extracted from The Multicenter Osteoarthritis Study (MOST) (n = 18,436 knees). Patellar region-of-interest (ROI) was first automatically detected, and subsequently, end-to-end deep convolutional neural networks (CNNs) were trained and validated to detect the status of patellofemoral OA. Patellar ROI was detected using deep-learning-based object detection method. Manual PFOA status assessment p…
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Medical Research Center（医学研究中心）
Objective is to assess the ability of texture features for detecting radiographic patellofemoral osteoarthritis (PFOA) from knee lateral view radiographs. We used lateral view knee radiographs from MOST public use datasets (n = 5507 knees). Patellar region-of-interest (ROI) was automatically detected using landmark detection tool (BoneFinder). Hand-crafted features, based on LocalBinary Patterns (LBP), were then extracted to describe the patellar texture. First, a machine learning model (Gradient Boosting Machine) was trained to detect radiographic PFOA from the LBP features. Furthermore, we u…
Insight Centre for Data Analytics（洞察数据分析中心）；Dublin City University（都柏林城市大学）
This chapter presents the investigations and the results of feature learning using convolutional neural networks to automatically assess knee osteoarthritis (OA) severity and the associated clinical and diagnostic features of knee OA from X-ray images. Also, this chapter demonstrates that feature learning in a supervised manner is more effective than using conventional handcrafted features for automatic detection of knee joints and fine-grained knee OA image classification. In the general machine learning approach to automatically assess knee OA severity, the first step is to localize the regi…
Knee Osteoarthritis Severity Prediction using an Attentive Multi-Scale Deep Convolutional Neural Network
Indian Institute of Technology Guwahati（印度古瓦哈蒂印度理工学院）；Cleveland Clinic（克利夫兰诊所）；Duke-NUS Medical School（杜克-新加坡国立大学医学院）；National University of Singapore（新加坡国立大学）
Duke University（杜克大学）；Duke Clinical Research Institute（杜克临床研究所）；Duke-Margolis Center for Health Policy（杜克-马戈利斯卫生政策中心）；Duke Cancer Institute（杜克癌症研究所）
The assessment of knee osteoarthritis (KOA) severity on knee X-rays is a central criteria for the use of total knee arthroplasty. However, this assessment suffers from imprecise standards and a remarkably high inter-reader variability. An algorithmic, automated assessment of KOA severity could improve overall outcomes of knee replacement procedures by increasing the appropriateness of its use. We propose a novel deep learning-based five-step algorithm to automatically grade KOA from posterior-anterior (PA) views of radiographs: (1) image preprocessing (2) localization of knees joints in the im…
Self-Supervised Learning for Knee Osteoarthritis: Diagnostic Limitations and Prognostic Value of Hospital Data
Department of Physics, J.K. Institute of Science（物理系，J.K. 科学研究所）；World Scientific University（世界科学大学）；University of Intelligent Studies（智能研究大学）；Center for Data Science, New York University（数据科学中心，纽约大学）；Bernard and Irene Schwartz Center for Biomedical Imaging, New York University Langone Health（伯纳德和艾琳·施瓦茨生物医学成像中心，纽约大学朗格尼健康中心）；Department of Radiology, New York University Langone Health（放射学系，纽约大学朗格尼健康中心）；Perlmutter Cancer Center, New York University Langone Health（珀尔马特癌症中心，纽约大学朗格尼健康中心）
Insight Centre for Data Analytics（洞察数据分析中心）；National University of Ireland Galway（爱尔兰国立高威大学）；Dublin City University（都柏林城市大学）；School of Health and Human Performance（健康与人类表现学院）；ZB MED – Information Centre for Life Sciences（ZB MED——生命科学信息中心）；University of Cologne（科隆大学）；School of Mathematics, Statistics and Applied Mathematics（数学、统计与应用数学学院）
Knee osteoarthritis (KOA) is a disease that impairs knee function and causes pain. A radiologist reviews knee X-ray images and grades the severity level of the impairments according to the Kellgren and Lawrence grading scheme; a five-point ordinal scale (0--4). In this study, we used Elastic Net (EN) and Random Forests (RF) to build predictive models using patient assessment data (i.e. signs and symptoms of both knees and medication use) and a convolution neural network (CNN) trained using X-ray images only. Linear mixed effect models (LMM) were used to model the within subject correlation bet…
Rethinking Knee Osteoarthritis Severity Grading: A Few Shot Self-Supervised Contrastive Learning Approach
Science Foundation Ireland Centre for Research Training in Machine Learning（爱尔兰科学基金会机器学习研究培训中心）；School of Medicine（医学院）；School of Computer Science, University College Dublin（都柏林大学学院计算机科学学院）；Insight Centre for Data Analytics, University College Dublin（都柏林大学学院洞察数据分析中心）
Confidence-Driven Deep Learning Framework for Early Detection of Knee Osteoarthritis
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；University Sorbonne Paris Nord（巴黎北索邦大学）；Jiangsu Institute of Hematology（江苏血液学研究所）；The First Affiliated Hospital of Soochow University（苏州大学附属第一医院）；Henan University of Chinese Medicine（河南中医药大学）；German Cancer Research Center（德国癌症研究中心）；Athinoula A. Martinos Centre for Biomedical Imaging（阿西诺拉·A.马蒂诺斯生物医学影像中心）；Geneva University Hospital（日内瓦大学医院）；IDP Institute（IDP研究所）；University of Orleans（奥尔良大学）
